农村埃塞俄比亚产后抑郁症状妇女的应对策略：一项横断面社区研究。
Coping strategies of women with postpartum depression symptoms in rural Ethiopia: a cross-sectional community study.
机构信息
University of Gondar, College of Medicine and Health Sciences, Department of Health Education and Behavioral Sciences, Gondar, Ethiopia.
Addis Ababa University, Department of Psychiatry, School of Medicine, College of Health Sciences, 9086, Addis Ababa, PO, Ethiopia.
出版信息
BMC Psychiatry. 2018 Feb 8;18(1):41. doi: 10.1186/s12888-018-1624-z.
BACKGROUND
Most women with postpartum depression (PPD) in low- and middle-income countries remain undiagnosed and untreated, despite evidence for adverse effects on the woman and her child. The aim of this study was to identify the coping strategies used by women with PPD symptoms in rural Ethiopia to inform the development of socio-culturally appropriate interventions.
METHODS
A population-based, cross-sectional study was conducted in a predominantly rural district in southern Ethiopia. All women with live infants between one and 12 months post-partum (n = 3147) were screened for depression symptoms using the validated Patient Health Questionnaire, 9 item version (PHQ-9). Those scoring five or more, 'high PPD symptoms', (n = 385) were included in this study. The Brief Coping with Problems Experienced (COPE-28) scale was used to assess coping strategies. Construct validity of the brief COPE was evaluated using confirmatory factor analysis.
RESULTS
Confirmatory factor analysis of the brief COPE scale supported the previously hypothesized three dimensions of coping (problem-focused, emotion-focused, and dysfunctional). Emotion-focused coping was the most commonly employed coping strategy by women with PPD symptoms. Urban residence was associated positively with all three dimensions of coping. Women who had attended formal education and who attributed their symptoms to a physical cause were more likely to use both problem-focused and emotion-focused coping strategies. Women with better subjective wealth and those who perceived that their husband drank too much alcohol were more likely to use emotion-focused coping. Dysfunctional coping strategies were reported by women who had a poor relationship with their husbands.
CONCLUSIONS
As in high-income countries, women with PPD symptoms were most likely to use emotion-focused and dysfunctional coping strategies. Poverty and the low level of awareness of depression as an illness may additionally impede problem-solving attempts to cope. Prospective studies are needed to understand the prognostic significance of coping styles in this setting and to inform psychosocial intervention development.
背景
尽管有证据表明产后抑郁症（PPD）对女性及其子女有不良影响，但在中低收入国家，大多数患有 PPD 的女性仍未被诊断和治疗。本研究旨在确定埃塞俄比亚农村地区患有 PPD 症状的女性所采用的应对策略，以为制定适合社会文化的干预措施提供信息。
方法
本研究为基于人群的横断面研究，在埃塞俄比亚南部一个以农村为主的地区进行。所有产后 1 至 12 个月的活产婴儿的母亲（n=3147）都使用经过验证的患者健康问卷 9 项版本（PHQ-9）筛查抑郁症状。将 PHQ-9 评分≥5 分的“高 PPD 症状”（n=385）母亲纳入本研究。使用Brief Coping with Problems Experienced（COPE-28）量表评估应对策略。采用验证性因子分析评估简短 COPE 的结构效度。
结果
简短 COPE 量表的验证性因子分析支持之前假设的三个应对维度（问题聚焦、情绪聚焦和功能失调）。情绪聚焦应对是患有 PPD 症状的女性最常采用的应对策略。城市居住与所有三个应对维度呈正相关。接受过正规教育且将症状归因于身体原因的女性更有可能使用问题聚焦和情绪聚焦应对策略。主观财富较好的女性和认为丈夫饮酒过量的女性更有可能使用情绪聚焦应对策略。与丈夫关系不好的女性报告使用功能失调的应对策略。
结论
与高收入国家一样，患有 PPD 症状的女性最有可能使用情绪聚焦和功能失调的应对策略。贫困和对抑郁症作为一种疾病的认识水平较低可能会进一步阻碍解决问题的应对尝试。需要前瞻性研究来了解这种环境下应对方式的预后意义，并为心理社会干预措施的制定提供信息。
Zotero 插件